Impact of abdominal drainage time and bed rest duration on postoperative recovery in patients undergoing laparoscopic appendectomy: a single-center retrospective study.
- 1Department of General Surgery, Renji Hospital, School of Medicine, Chongqing University, Chongqing, China; The Fifth People's Hospital of Chongqing, Nan'an District, No.121 Wangxi Road, Chongqing, 400000, China. [email protected].
- 2Department of General Surgery, Renji Hospital, School of Medicine, Chongqing University, Chongqing, China; The Fifth People's Hospital of Chongqing, Nan'an District, No.121 Wangxi Road, Chongqing, 400000, China.
Abstract
Background
The optimal duration of abdominal drainage and bed rest after laparoscopic appendectomy (LA) remains uncertain. This study investigated whether these modifiable factors are associated with residual intra-abdominal infection (RII) and prolonged length of hospital stay (LOS).Objective
To retrospectively analyze the risk factors for RII and prolonged LOS following LA and clarify the impact of abdominal drainage time and bed rest duration on postoperative recovery.Methods
This retrospective study included 478 adults who underwent LA for acute appendicitis (2017-2020). Patients were followed weekly for 4 weeks. RII was defined as a composite endpoint occurring between postoperative day 5 and 4 weeks. Multivariable logistic regression identified factors associated with RII and prolonged LOS (≥5 days). Subgroup analyses were exploratory due to small sample sizes.Results
RII occurred in 59 patients (12.3%). In the overall cohort, independent factors for RII were complicated appendicitis (OR 4.35), drainage ≥36 h (OR 3.69), bed rest ≥24 h (OR 3.27), and Neutrophil-to-lymphocyte ratio (NLR) ≥6.64 (OR 3.18) (all P<0.05). Drainage <36 h was not associated with increased risk. Exploratory subgroup analyses suggested drainage ≥36 h as the only factor for RII in uncomplicated appendicitis (OR 7.47), while bed rest ≥24 h (OR 7.21), elevated White blood cell count (WBC) (OR 4.65), and NLR (OR 6.02) were associated in complicated appendicitis. For prolonged LOS (198 events), independent factors were surgical complications (OR 6.14) and drainage ≥36 h (OR 4.74). Exploratory subgroup analyses showed surgical complications and drainage ≥36 h were significant in uncomplicated appendicitis, while only surgical complications remained in complicated appendicitis.Conclusion
Prolonged drainage (≥36 h) and bed rest (≥24 h) were associated with increased RII in the overall cohort; however, sensitivity analysis revealed variability in effect estimates, underscoring the need for cautious interpretation. Subgroup findings are exploratory and require confirmation. Prolonged drainage and surgical complications were associated with longer LOS. Drainage <36 h appeared safe. These findings suggest potential benefits of avoiding routine drainage, early drain removal, and early mobilization, but require confirmation in larger prospective studies.
Related
- Preoperative and early postoperative predictors of nausea and vomiting after laparoscopic abdominal surgery in an enhanced recovery programme
- Comparison of Postoperative Analgesic Efficacy Between Opioid-free Anaesthesia Using Intravenous Magnesium, Lidocaine, and Erector Spinae Plane Block, and Opioid-based Anaesthesia in Laparoscopic Abdominal Surgeries: A Randomised Controlled Trial
- Association of appendicolith with postoperative complications, wound infection, and length of stay after appendectomy: a retrospective observational study from Palestine.
- Association between anesthetic fresh gas flow and postoperative inflammatory response in laparoscopic sleeve gastrectomy : A retrospective cohort study
- Multidimensional prognostic value of preoperative Prognostic Nutritional Index for postoperative outcomes in older adults undergoing major open abdominal surgery.
BibTeX
@article{xie2026impact,
title = {{Impact of abdominal drainage time and bed rest duration on postoperative recovery in patients undergoing laparoscopic appendectomy: a single-center retrospective study.}},
author = {Yong Xie and Xiao Liu and Xiu-Zhen Qian},
journal = {BMC surgery},
year = {2026},
month = jul,
doi = {10.1186/s12893-026-04074-w},
url = {https://europepmc.org/article/MED/42902296},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Impact of abdominal drainage time and bed rest duration on postoperative recovery in patients undergoing laparoscopic appendectomy: a single-center retrospective study.
AU - Yong Xie
AU - Xiao Liu
AU - Xiu-Zhen Qian
PY - 2026
DA - 2026/07/01
JO - BMC surgery
DO - 10.1186/s12893-026-04074-w
UR - https://europepmc.org/article/MED/42902296
AB - Background The optimal duration of abdominal drainage and bed rest after laparoscopic appendectomy (LA) remains uncertain. This study investigated whether these modifiable factors are associated with residual intra-abdominal infection (RII) and prolonged length of hospital stay (LOS).Objective To retrospectively analyze the risk factors for RII and prolonged LOS following LA and clarify the impact of abdominal drainage time and bed rest duration on postoperative recovery.Methods This retrospective study included 478 adults who underwent LA for acute appendicitis (2017-2020). Patients were followed weekly for 4 weeks. RII was defined as a composite endpoint occurring between postoperative day 5 and 4 weeks. Multivariable logistic regression identified factors associated with RII and prolonged LOS (≥5 days). Subgroup analyses were exploratory due to small sample sizes.Results RII occurred in 59 patients (12.3%). In the overall cohort, independent factors for RII were complicated appendicitis (OR 4.35), drainage ≥36 h (OR 3.69), bed rest ≥24 h (OR 3.27), and Neutrophil-to-lymphocyte ratio (NLR) ≥6.64 (OR 3.18) (all P<0.05). Drainage <36 h was not associated with increased risk. Exploratory subgroup analyses suggested drainage ≥36 h as the only factor for RII in uncomplicated appendicitis (OR 7.47), while bed rest ≥24 h (OR 7.21), elevated White blood cell count (WBC) (OR 4.65), and NLR (OR 6.02) were associated in complicated appendicitis. For prolonged LOS (198 events), independent factors were surgical complications (OR 6.14) and drainage ≥36 h (OR 4.74). Exploratory subgroup analyses showed surgical complications and drainage ≥36 h were significant in uncomplicated appendicitis, while only surgical complications remained in complicated appendicitis.Conclusion Prolonged drainage (≥36 h) and bed rest (≥24 h) were associated with increased RII in the overall cohort; however, sensitivity analysis revealed variability in effect estimates, underscoring the need for cautious interpretation. Subgroup findings are exploratory and require confirmation. Prolonged drainage and surgical complications were associated with longer LOS. Drainage <36 h appeared safe. These findings suggest potential benefits of avoiding routine drainage, early drain removal, and early mobilization, but require confirmation in larger prospective studies.
SN - 1471-2482
ER -